ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2022
Evaluating disparities in access to obstetric services for American Indian women across Montana.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Maternal Weathering and Infant Health: Understanding Low Birth Weight and Preterm Birth Among American Indians.Journal of racial and ethnic health disparities · 2026Article
- Seasonality, Weather, and Obstetric Level of Care: An Analysis of Rural Delivery Locations.International journal of environmental research and public health · 2026Article
- Pregnancy as a journey of care and connection: Indigenous women's experiences navigating health systems and community support.Frontiers in public health · 2026Article
- Inclusive data practices: disaggregating race and assessing comorbidities among American Indian and Alaska Native individuals in PRAMS.Ethnicity & health · 2025Article
- Access to pediatric extracorporeal membrane oxygenation: a geospatial analysis of the racial/ethnic composition of areas with and without access.International journal for equity in health · 2025Article
- Barriers and facilitators to contraception provision among rural healthcare providers.Contraception and reproductive medicine · 2025Article
- Obstetric care in rural critical access hospitals: A domestic application of the World Health Organization Emergency Obstetric Care framework in rural communities.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Inferred Attractiveness Gravity-Based Models for Estimating Realized Access at Rural Hospitals.The Journal of the Operational Research Society · 2025Article
- Social and geographical disparities in adverse birth outcomes in Alaska: a retrospective cohort study.BMJ public health · 2025Article
- Racial and Ethnic and Rural Variations in the Use of Hybrid Prenatal Care in the US.JAMA network open · 2024Article
- Global inequities in adverse pregnancy outcomes: what can we do?AJOG global reports · 2024Article
- The implications of using maternity care deserts to measure progress in access to obstetric care: a mixed-integer optimization analysis.BMC health services research · 2024Article
- Dual Barriers: Examining Digital Access and Travel Burdens to Hospital Maternity Care Access in the United States, 2020.The Milbank quarterly · 2023Article
- Operationalizing risk-appropriate perinatal care in a rural US State: directions for policy and practice.BMC health services research · 2023Article
- American Indians travel great distances for obstetrical care: Examining rural and racial disparities.Social science & medicine (1982) · 2023Article
- Geographic proximity to immunization providers and vaccine series completion among children ages 0-24 months.Vaccine · 2023Article
- Determinants of ethnic differences in the uptake of child healthcare services in New Zealand: a decomposition analysis.International journal for equity in health · 2023Article
- The Role of Family Medicine in Addressing the Maternal Health Crisis in the United States.Journal of primary care & community healthReview
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
purposePregnant women across the rural United States have increasingly limited access to obstetric care, especially specialty care for high-risk women and infants. Limited research focuses on access for rural American Indian/Alaskan Native (AIAN) women, a population warranting attention given persistent inequalities in birth outcomes.
methodsUsing Montana birth certificate data (2014-2018), we examined variation in travel time to give birth and access to different levels of obstetric care (i.e., the proportion of individuals living within 1- and 2-h drives to facilities), by rurality (Rural-Urban Continuum Code) and race (White and AIAN people).
findingsResults point to limited obstetric care access in remote rural areas in Montana, especially higher-level specialty care, compared to urban or urban-adjacent rural areas. AIAN women traveled significantly farther than White women to access care (24.2 min farther on average), even compared to White women from similarly rural areas (5-13 min farther, after controlling for sociodemographic characteristics, risk factors, and health care utilization). AIAN women were 20 times more likely to give birth at a hospital without obstetric services and had less access to complex obstetric care. Poor access was particularly pronounced among reservation-dwelling AIAN women.
conclusionsIt is imperative to consider racial disparities and health inequities underlying poor access to obstetric services across rural America. Current federal policies aim to reduce maternity care professional shortages. Our findings suggest that racial disparities in access to complex obstetric care will persist in Montana unless facility-level infrastructure is also expanded to reach areas serving AIAN women.
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